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chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease
The accumulating body of evidence suggests that the liver toxicity of AFs is mainly associated with oxidative/nitrosative stress, cellular apoptosis, mitochondrial dysfunction, lipid/protein peroxidation, construction of AFs-DNA adducts, DNA damage, induction of genomic mutation, inhibition of tumor suppressor proteins, up-regulation of gene expression, induction of inflammatory signaling pathways (440)